University Hospital In Turkey Research Articles

An outbreak of Ralstonia insidiosa bloodstream infections caused by contaminated heparinized syringes

IntroductionRalstonia insidiosa, a gram-negative waterborne bacteria able to survive and grow in any type of water source, can cause nosocomial infections, and are considered emerging pathogens of infectious diseases in hospital settings. In this study, we report an outbreak of R. insidiosa at our center related to contaminated heparinized syringes. Material and methodsThe present study was conducted in a tertiary care university hospital in Turkey. An outbreak analysis was performed between September 2021 and December 2021. Microbiological samples were obtained from environmental sources and from patient blood cultures. Species identification was performed using matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS). To investigate the clonality of strains, all confirmed isolates were sent to the National Reference Laboratory and pulsed-field gel electrophoresis (PFGE) was used to perform molecular typing. ResultsSeventeen R. insidiosa isolates were identified from the blood cultures of 13 patients from various wards and intensive care units. Isolates from seven patient blood cultures and two heparinized blood gas syringes were characterized by PFGE. All isolates were found to belong to the same clone of R. insidiosa. ConclusionR. insidiosa was identified as the cause of a nosocomial infection outbreak in our hospital, which was then rapidly controlled by the infection-control team. When rare waterborne microorganisms grow in blood or other body fluid cultures, clinicians and the infection-control team should be made aware of a possible outbreak.

A year and a half later: Clinical experiences of intern nursing students in the COVID-19 Pandemic: A constructivist grounded theory

AimsThe aim of this study is to develop a theory to explore the clinical experiences of interns in clinical practice during the COVID-19 pandemic. BackgroundThe COVID-19 pandemic is a serious public health problem influencing the healthcare systems worldwide. Nursing students were excluded from clinical practice for a long time due to the pandemic. However, the prolonged and uncertain pandemic conditions required the inclusion of fourth-year nursing students in clinical practice. DesignA qualitative research design based on the Constructivist Grounded Theory approach was used in this study. MethodsThe research data were collected from fourth-year nursing students doing an internship at a university hospital in Turkey. Fourteen nursing students (12 females and 2 males) in the clinical practice during the COVID-19 pandemic with a mean age of 22.64 ± 0.225 were included in the study. In the collection of data, firstly, the purposeful sample selection method, then the theoretical sample selection method was used. On the online interview platform, the data were collected through individual interviews with those agreeing to participate in the study between July 2021 and August 2021 using a semi-structured interview form. The results were analyzed with initial, focused and theoretical coding. The research was reported based on the Consolidated Criteria for Reporting Qualitative Research guide. ResultsA core category and five main categories emerged in the study. The core category is a lonely bird and the main categories are emotions, challenges, coping methods, nursing experiences and solution suggestions. ConclusionsThis research can help create a conceptual framework of clinical practice experiences of intern nursing students during the COVID-19 pandemic. It is thought that intern nursing students need to be supported by reliable authorities before and during the internship. Intern students stated that they experienced many emotions together and felt alone. Our study results revealed that intern nurses need more psychological support, especially during the pandemic period. A remarkable finding of the research is that interns now think of themselves as professional nurses. For interns to develop effective coping methods, intensive and regular training should be organized in cooperation with the hospital and school administration.

Evaluation of psychiatrist’s communication with psychosis patients

Evaluation of the physician-patient relationship is very important in determining priorities in medical practice and medicine. For this purpose, in this study the psychiatrist’s communication with psychotic patients as a sensitive group was evaluated. A questionnaire was administered to 210 patients in a psychiatric clinic of Inonu University Hospital in Turkey to determine how the examination is performed in the facility for outpatients in the psychosis unit. According to the study conducted, it was observed that the evaluation score of the psychiatrist’s communication with psychotic patients increased positively with increasing consultation duration. Our work is particularly noteworthy because it deals with a sensitive area, such as a group of psychiatric patients. The scores were obtained based on data from the evaluation of the questionnaires, which showed that the communication between the psychiatrist and the psychotic patient was conducted in a sensitive and careful manner, and without ethical problems.

Role of red cell dstribution width in colorectal cancer diagnosis and prognosis

Objective: We aimed to assess whether red cell distribution width (RDW) was associated with pre-operative clinical features or post-operative clinicopathological outcomes in patients with colorectal cancer (CRC), and to determine the utility of RDW as a diagnostic or prognostic marker of CRC. Material and Method: This retrospective cohort study was conducted between January 2018 and May 2021 at a university hospital in Turkey. A total of 188 patients histologically diagnosed with CRC who had undergone surgery were included in the study. Results: Our study included 118 (62.77%) male patients, and the mean age of the patients was 66.28±11.71 years. We found that RDW values were significantly higher in females compared to males (p=0.033), in patients with T3 or T4 tumors compared to those with T1 or T2 tumors (p

Metagenomic analysis of wastewater phageome from a University Hospital in Turkey.

Phage DNA analysis gives opportunity to understand living ecosystem of the environment where the samples are taken. In the present study, we analyzed phage DNA obtained from wastewater sample of university hospital sewage. After filtration, long high-speed centrifugation was done to collect phages. DNA was extracted from pellet by phenol chloroform extraction and used for NGS sequencing. The host profile, taxonomic and functional analyses were performed using MG-RAST, and ResFinder program was used for resistance gene detection. High amounts of reads belong to bacteriophage groups (~ 95%) from our DNA sample were obtained and all bacteriophage reads were found belonging to Caudovirales order and Myoviridae (56%), Siphoviridae (43%), and Podoviridae (0.02%) families. The most common host genera were Escherichia (88.20%), Salmonella (5.49%) and Staphylococcus (5.19%). SEED subsystems hits were mostly structural parts and KEGG Orthology hits were nucleotide- and carbohydrate metabolism-related genes. No anti-microbial resistance genes were detected. Our bacteriophage DNA purification method is favorable for phage metagenomic studies. Dominance of coliphages may explain infrequent Podoviridae. Dominancy of structural genes and auxiliary genes is probably due to abundance of lytic phages in our sample. Absence of antibiotic resistance genes even in hospital environment phages indicates that phages are not important carrier of resistance genes.

The impact of family-centered care interventions on neonatal and parental outcomes in a Turkish hospital

AimThis study aimed to improve nurses’ attitudes towards parental engagement and to examine the impact of implementing nursing interventions related to family-centred care on neonatal and parental outcomes in a university hospital in Turkey. MethodsA quasi-experimental, nonequivalent, and post-test research design was used. Using convenience sampling, the study was completed with 128 preterm infants and their parents, including 64 in the experimental group and 64 in the control group at a neonatal intensive care unit of a university hospital. The control group data were collected from medical records and parents before practising family-centred nursing interventions developed for the experimental group. In addition, nurses were given a four hour training session aimed to improve their attitudes towards parental participation in care, with the nurses’ attitudes measured before, immediately after, and one month after the training. The experimental group data were collected from medical records and parents after 10 nursing interventions based on family-centred care supported by managers began to be implemented by trained nurses in the neonatal intensive care unit. The Parent-Preterm Infant Characteristics Form, Maternal Attachment Inventory, Empowerment of Parents in the Intensive Care-Neonatology (EMPATHIC-N), and Parental Engagement Attitude Scale were used for the data collection. FindingsWhile nurses’ scores of attitudes toward parental participation obtained immediately after and one month after the training were higher than those before the training, the scores one month after were lower compared to those immediately after. The results indicated that discharge weight gain of infants in the experimental group were significantly higher than those in the control group and that there was no significant difference between the groups in length of stay at neonatal intensive care unit. The maternal attachment and satisfaction scores of the parents in the experimental group were significantly higher than those in the control group. ConclusionImplementing family-centred nursing care interventions, developed based on unit needs and supported by managers, with trained neonatal intensive care nurses positively impacted parent-infant attachment, parent satisfaction, and infant weight gain.

Post-traumatic Growth in Cancer Patients: A Correlational Study in Turkey.

This study aims to evaluate the factors that influence post-traumatic growth (PTG), including religious coping and resilience. This descriptive and correlational study involved 111 cancer patients, followed up at a hematology inpatient clinic of a university hospital in Turkey. Religious coping scale, resilience scale, and PTG inventory were used for data collection. PTG was positively associated with negative religious coping and was negatively associated with age. PTG scores were higher for patients without children, who were recently diagnosed, had higher knowledge about the disease, and used negative religious coping.

The Effect of Mindfulness-Based Breathing and Music Therapy Practice on Nurses' Stress, Work-Related Strain, and Psychological Well-being During the COVID-19 Pandemic: A Randomized Controlled Trial.

Infectious diseases cause psychological problems for health care workers and especially nurses. Nurses who provided coronavirus disease-2019 (COVID-19) patients with care experience negative feelings such as stress, work-related strain, discomfort, and helplessness related to their high-intensity work. The aims of this study are to investigate the effect of the mindfulness-based breathing and music therapy practice on stress, work-related strain, and psychological well-being levels of nurses who provided COVID-19 patients with care. This randomized controlled trial was conducted in a COVID-19 department at a university hospital in Turkey. Nurses who care for patients infected with COVID-19 were randomly divided into an intervention group (n = 52) and a no-treatment control group (n = 52). The intervention group received mindfulness-based breathing and music therapy. In data collection, the Personal Information Form, State Anxiety Inventory, Work-Related Strain Scale, and Psychological Well-Being Scale were used. The data from the study showed that mindfulness-based breathing and music therapy decreased stress and work-related strain (P < .05) and increased psychological well-being (P < .05). The control group showed no statistically significant changes on these measures (P > .05). The mindfulness-based breathing and music therapy practice reduced nurses' stress and work-related strain and increased psychological well-being during the COVID-19 pandemic.

The Patient Perspective of Telemedicine in the Context of COVID-19 Pandemic.

COVID-19 Pandemic might be considered as a catalyst for transformation in healthcare experience via the use of video consultation as a method for telemedicine. The aim of our qualitative study is to understand the patient perception of video consultations in telemedicine, which has been used by a single pulmonologist in only one university hospital in Turkey since the first three months of the pandemic. Research findings are essential when it comes to a more effective and widespread future use of telemedicine, as it focuses on patient experience about a medical technology that is newly introduced. Totally 30 patients were randomly chosen and interviewed who get healthcare support via telemedicine. A semi-structured questionnaire was used to learn the experiences and opinions of the interviewees. The expressions of the patients highlight some advantages of using telemedicine such as being free from risk of contagion caused by exposure in the hospital, being able to save time and money while reaching to the physician online whenever needed, and success in technical details even though they were experiencing it for the first time. A very few of the patients are feeling discomfort to be in front of the screen. Almost all patients are applicants to suggest to other individuals the system they used, in conditions to be appropriate, and continuity after the pandemic period. Since the pandemic has propagated from one patient, the worldwide implementation of telemedicine might be catalyzed by following in the footsteps of the sporadic examples of decisiveness nourished from patient experiences.

Hemşirelerin Kan Basıncı Ölçümü Hakkındaki Bilgileri Uygulamalarını Etkiler mi?

Aim: This study was performed to evaluate whether nurses follow the measurement steps accurately while measuring blood pressure, whether they have accurate information about the procedure, and whether they apply their knowledge correctly during practice. Material and Methods: This observational study was conducted with 106 nurses working in the internal medicine and surgical department of a university hospital in Turkey from March 15 to May 15, 2016. In the study, nurses' knowledge and application of the measurement steps were determined by observation and face-to-face interview methods. The obtained data were recorded in the information and observation forms. The same researcher made all observations, and each nurse was observed once. Results: None of the participants fulfilled the following four steps in measuring blood pressure 1) "allowing 30 minutes for the patient to relax if the patient is tired or has been smoking", 2) "inflating the blood pressure cuff until radial artery pulse is lost", 3) "waiting for one minute following the deflation of the blood pressure", 4) "inflating the blood pressure cuff until the scale reads around 30 mm Hg above the reading from the radial artery". In contrast, a considerable proportion (respectively, 77.4%, 71%, 70%, 60%) of nurses knew these steps. Further, none of the nurses who accurately knew the same steps performed them in practice (p&amp;lt;0.05). Conclusions: The study showed that while measuring blood pressure, the nurses did not comply with the steps for measuring blood pressure and did not put their theoretical knowledge of the required steps for the procedure into practice.

EVALUATION OF COVID-19 PERCEPTIONS AND COMPLIANCE WITH ISOLATION PRECAUTIONS OF HEALTH PROFESSIONALS WITHIN SCOPE OF HEALTH BELIEF MODEL

This study was carried out to evaluate health professionals' perceptions of COVID-19 and their compliance with isolation precautions within the scope of the Health Belief Model. The population of this cross-sectional study consisted of 1500 health professionals comprising physicians and nurses who work in a university hospital in Turkey between 10 May and 30 May 2020, while its sample consisted of 309 health professionals accepting to participate in the study. In the data collection, descriptive characteristics form which was prepared by the researchers, the COVID-19 Perception Questionnaire prepared within the scope of the Health Belief Model, and the Isolation Precautions Compliance Scale were used. The mean scores of perceived susceptibility, perceived severity, perceived benefits, perceived health-motivation, perceived self-efficacy, cues to action, and the total mean score of the COVID-19 Perception Questionnaire were found to be above the average. Whereas, the perceived barriers mean score was found to be below the average. Perceived susceptibility, perceived severity, and cues to action mean scores of the nurses were significantly higher than those of the physicians. The compliance of health professionals with isolation was also above the average, and nurses' mean score of compliance with the isolation precautions is significantly higher than those of physicians. The increased perception of the COVID-19 epidemic based on the Health Belief Model positively affects the compliance of health professionals to isolation. The development of certain strategies be recommended that increase health professionals’ perception of the COVID-19 outbreak and their compliance with the isolation precautions.

THE EFFECT OF PAINTING ART ON POST-OPERATIVE HOPELESSNESS AND FATIGUE IN BREAST CANCER PATIENTS / A SEMI-EXPERIMENTAL STUDY

Hopelessness and fatigue are common symptoms experienced by breast cancer patients in the post-operative period. Supportive interventions, such as art making or art therapy, are reported to have a positive effect on the symptoms experienced by cancer patients. This semi experimental study aims to evaluate the effect of painting on post-operative hopelessness and fatigue in breast cancer patients. The population of the study consisted of all adult patients who had surgery for breast cancer in a university hospital in Turkey and lived in the city center. The sample of the study consisted of 110 patients, 55 in the experimental group and 55 in the control group. The sample included patients who were selected through the improbable random sampling method. The research was completed between April 2016 and January 2018. Patient Information Form, Piper Fatigue Scale and Beck Hopelessness Scale were used to obtain data. Percentage, mean, standard deviation, chi-square, independent group’s t test, paired t test and correlation were used in the analysis of the data. It was observed that the hopelessness and fatigue scores of the patients in the experimental group decreased statistically significantly after the painting study (p=0.001). No statistically significant change was observed in the hopelessness and fatigue scores of the patients in the control group. In this context, it is thought that nurses should know the effect of painting on hopelessness and fatigue and include it in their practices. It may be recommended to conduct new studies in order to evaluate the effects of painting on different patient groups.

The relationship between nurses' job satisfaction levels and quality of life.

The aim of this study is to determine the relationship between nurses' job satisfaction levels and quality of life. This cross-sectional study was conducted on 225 nurses working in a university hospital in Turkey. Nurse Information Form, Minnesota Satisfaction Questionnaire (MSQ), and The World Health Organization Quality of Life Instrument-WHOQOL-BREF (TR) were used to collect the data. It was determined that while the MSQ mean score of the nurses was low, their WHOQOL-BREF mean score was moderate. A positive statistically significant and linear correlation was determined between job satisfaction and quality of life (p < 0.01). While the nurses' MSQ score increased, their WHOQOL-BREF score also increased. As job satisfaction of nurses increases, both their quality of life and quality of nursing care will be enhanced.

Determine the Symptom Intensities, Performance and Hopelessness Levels of Advanced Lung Cancer Patients for the Palliative Care Approach.

This research was conducted descriptively to determine the symptom intensities, performance and hopelessness levels of advanced lung cancer patients for the palliative care approach. The research sample consisted of 130 patients with advanced lung cancer, who were selected from 600 lung cancer populations in thoracic surgery and intensive care, outpatient chemotherapy, oncology in a university hospital in Turkey. Ethics Committee permission and the patients’ written consent was obtained. Study data were collected face to face between January 2020 and July 2020 using the Edmonton Symptom Assessment System, Karnofsky Performance and Beck Hopelessness Scale. The mean age of the patients was 62.68 ± 8.867, 72.3% were males, and 89.2% were not currently working. The most common symptom in the patients was found to be fatigue 5.46 ± 2.12, worsening in general health and well-being 5.69 ± 1.87, loss of appetite 5.40 ± 2.59, and total symptom score 47.17 ± 19.03. Feelings and expectations about the future 1.40 ± 1.66, loss of motivation 3.43 ± 2.41, hope 2.05 ± 1.75, and total score of hopelessness 7.41 ± 6.01. There was a positive correlation between the patients’ hopelessness level and their symptom burden, and a negative correlation was found with Karnofsky performance (P < .05). A significant difference was found between the patients’ age, months since diagnosis, gender, education and employment status, stage of the disease, presence of metastases and analgesic use, and hopelessness scores (P < .05). It was determined that the symptom burden of patients with advanced lung cancer increased and as their Karnofsky performance decreased, their hopelessness level further increased. Hopelessness scores are affected by the socio-demographic and disease variables of the patients.

Effects of the COVID-19 Pandemic on the Orthopedic Trauma Practice: Experiences From A University Hospital in Turkey

After a new type of coronavirus in Wuhan, China was found to cause deadly pneumonia, the World Health Organization declared the disease caused by the virus a pandemic on March 11, 2020. This situation led to the effectuation of some social restrictions that radically changed our daily lives in our country and across the world. This comprehensive change in social life also affected the daily practices in all branches of medicine as well as orthopedic trauma practice. The aim of this study was to evaluate the incidence, location, and treatment methods of the fractures seen in the pediatric and adult population during the pandemic period, and to investigate their differences with the pre-pandemic period. Our study was designed as a retrospective cohort study comparing the acute fractures admitted to our center during the pandemic period and the fractures that occurred before the pandemic. Patients who presented with a new fracture to our emergency ward or outpatient clinic between March 16, 2020, and December 30, 2020, when social restrictions were in effect in our country, were identified. Patients who applied to our center with a new fracture within the same date range in 2019 and 2018 were also identified. The patient group was determined by scanning the International Classification of Diseases code and orthopedic consultation charts on the database. After removing the duplicate records, the radiological examinations of all patients were evaluated by the researchers. The data regarding patients’ age, gender, fracture location, treatment types, length of hospital stay, and in-hospital mortality were recorded. The patients were divided into two groups: the pediatric group (16 years and younger) and the adult group (over 16 years). The total number of fractures in the pandemic period was significantly less than in the non-pandemic period (p<0.001). Although the number of fractures decreased significantly in both groups (p<0.001), there was no significant difference between the pandemic and non-pandemic period data regarding the age groups (p=0.771). The most common fracture sites were the distal radius (20% and 19.4%) and the ankle (8, 45% and 8.54%) in the non-pandemic period, while the distal radius (21.5%) and the proximal femur (10.8%) were the most involved sites in the pandemic period. The percentage of surgically treated fractures among all fractures was 49.6%, 46.6%, and 39.4% for 2018, 2019, and 2020, respectively. Although the prevalence of surgical treatments was lower in the pandemic period, the difference was not statistically significant (p=0.089). The mean length of hospital stay for the surgically treated fractures for all groups was 5.36±2.79, 5.78±2.41, and 4.10±1.62 days for the years 2018, 2019, and 2020, respectively. The decline in the length of stay during the pandemic period was found to be significant (p<0.001). We experienced some difficulties and confusion due to our lack of previous experience in orthopedic daily practices under the extraordinary conditions brought by the pandemic. We have seen how necessary and important previous experience can be in such extraordinary situations. The main motivation for us to carry out this study was to contribute to the knowledge in the literature. We observed a 26% decrease in the prevalence of fractures during the pandemic period. Although the indications for surgical treatment have not changed, we observed that the changes in the patient population and trauma mechanism also changed the treatment type.

An analysis of antibody response following the second dose of CoronaVac and humoral response after booster dose with BNT162b2 or CoronaVac among healthcare workers in Turkey.

Limited data are available on the short‐ to midterm levels of antibodies to the CoronaVac vaccine and quantitative change in humoral response after homologous or heterologous booster doses. In this prospective cohort study, we evaluated the anti‐receptor‐binding domain (RBD) immunoglobulin G (IgG) levels after two doses of CoronaVac and heterologous/homologous booster administration among healthcare workers in a university hospital in Turkey. Quantitative anti‐RBD IgG antibody levels were measured at first and fourth months in 560 healthcare workers who had completed two doses of CoronaVac vaccine, and within 2 months after the third dose of CoronaVac or BNT162b2. Participants were asked to complete a questionnaire during the first blood draw. The seropositivity rate was 98.9% and 89.1%, and the median antibody level was 469.2 AU/ml and 166.5 AU/ml at first and fourth month, respectively. In the fourth month, a mean reduction of 61.4% ± 20% in antibody levels was observed in 79.8% of the participants. The presence of chronic disease (odds ratio [OR]: 1.76, 95% confidence interval [CI]: 1.15–2.69) and being in the 36–50 age group (OR: 2.11, 95% CI: 1.39–3.19) were identified as independent predictors for low antibody response. The antibody level increased 104.8‐fold (median: 17 609.4 vs. 168 AU/ml) and 8.7‐fold (median: 1237.9 vs. 141.4 AU/ml) in the participants who received BNT162b2 and CoronaVac, respectively. During the follow‐up, 25 healthcare workers (4.5%) were infected with severe acute respiratory syndrome coronavirus 2. Considering the waning immunity and circulating variants, a single booster dose of messenger RNA vaccine seems reasonable after the inactivated vaccine especially in risk groups.

Assessment of Minimal Residual Disease in Childhood Acute Lymphoblastic Leukemia: A Multicenter Study From Turkey.

Assestment of minimal residual disease (MRD) in childhood acute lymphoblastic leukemia (ALL) is of utmost importance both for risk classification and tailoring of the therapy. The data of pediatric ALL patients that received treatment with Berlin-Frankfurt-Münster (BFM) protocols were retrospectively collected from 5 university hospitals in Turkey. Of the 1388 patients enrolled in the study 390 were treated according to MRD-based protocols. MRD assestment was with real time quantitative polymerase chain reaction (qPCR) in 283 patients and with multiparametric flow cytometry (MFC)-MRD in 107 patients. MRD monitoring had upstaged a total of 8 patients (2%) from intermediate risk group to high-risk group. Univariate analysis revealed age 10 years or above, prednisone poor response, PCR-MRD ≥10-3 on day 33 and on day 78 as poor prognostic factors affecting event-free survival (EFS). Detection of >10% blasts on day 15 with MFC (MFC-high-risk group) was not shown to affect EFS and/or overall survival (log-rank P=0.339). Multiple logistic regression analysis revealed PCR-MRD ≥10-3 on day 78 as the only poor prognostic factor affecting EFS (odds ratio: 8.03; 95% confidence interval: 2.5-25; P=0.000). It is very important to establish the infrastructure and ensure necessary standardization for both MRD methods for optimal management of children with ALL.

Association Between Nurses' Spirituality and Frequency of Spiritual Therapeutic Care in Turkey.

This study evaluated the association between nurse spirituality and frequency of spiritual care among 560 nurses working at Dicle University Hospital in Turkey. The Spirituality Scale and the Nurse Spiritual Care Therapeutic Scale were administered. Results indicated that scores on the Spirituality Scale were positively correlated with frequency of provision of spiritual care (Nurse Spiritual Care Therapeutic Scale). It was found that the spirituality levels of the nurses had a positive effect (R2 = 0.245, B = 0.391, p < 0.0001) on the frequency of providing spiritual curative care. It was determined that the frequency of providing spiritual care of nurses with high spirituality level increased. No significant associations were found between Nurse Spiritual Care Therapeutic Scale means of point and gender, marital status, education level, unit work, or duration of professional experience.

Skin-related problems associated with the use of personal protective equipment among health care workers during the COVID-19 pandemic: A online survey study

AimThe aim of this study was to determine the skin-related problems caused by personal protective equipment (PPE) use in health care workers (HCWs) and to identify the factors contributing to their occurrence. Materials and MethodsThis descriptive and cross-sectional online survey study was carried out with 297 HCWs working in a university hospital in Turkey between March 20, 2021, and May 20, 2021. The study data was collected using an online questionnaire consisting of 3 parts. Descriptive statistics, Pearson's Chi-square, and Fisher's Exact Chi-square tests were used to analyze the data. ResultsAmong the HCWs, 95.6% reported that skin-related problems associated with at least one PPE use. Skin-related problems that develop due to PPE use were mostly associated with the use of Surgical/N95 masks (97.1%) and gloves (96.8%). The most commonly reported problems were ''dryness'' (%74.0) and ''itching'' (%72.1) when wearing gloves, ''perspiration and moisture'' (73.6%), ''formation of equipment traces'' (53.9%), and ''skin lesions'' (52.8%) when wearing a surgical/N95 mask, ''perspiration and moisture'' (89.7%) when wearing protective overalls/gowns. Wearing PPE for more than 4h (p=0.001), taking additional precautions to increase the sense of protection (p=0.026), and not applying preventive measures while using PPE (p=0.003) significantly increase the risk of skin-related problems. ConclusionThe results suggest that skin-related problems due to the use of PPE are common among HCWs.

The effect of training given using three different methods on genital hygiene behaviours after medical curettage

This research was conducted to determine the effect of genital hygiene training given with three different methods after medical curettage on genital hygiene behaviours. A randomised semi-experimental study was performed with 90 patients who underwent medical curettage at a university hospital in Turkey. The participants were divided into three equal groups: verbal training, training with written materials, and demonstration only. Data was collected using the Patient Information Form and the Genital Hygiene Behaviour Scale. There was no difference between mean pre-training and post-training Genital Hygiene Behaviours Scale total and sub-dimension scores in the verbal group (p > .05). There was a difference between the groups after the training between the mean total and sub-dimensions of the Genital Hygiene Behaviour Scale scores (p < .05). The study findings showed that the demonstration method in genital hygiene training given to participants who underwent medical curettage was more effective in improving genital hygiene behaviours than other methods. IMPACT STATEMENT What is already known on this subject? It is seen that verbal education alone is not effective in providing and developing genital hygiene behaviours. Although studies are investigating the effectiveness of education on genital hygiene behaviours of women, there is no study investigating the effectiveness of education methods. What do the results of this study add? The demonstration method for the development of genital hygiene behaviours is more effective than verbal and written education methods. What are the implications of these findings for clinical practice and/or further research? This study provides evidence for the effectiveness of training methods for the development of genital hygiene behaviours. Nurses' preference for demonstration methods in genital hygiene education programs may contribute to the protection and development of health by facilitating the teaching of correct health behaviours.